Because it works to relieve anxiety and depression so rapidly and is so safe, GHB has been recommended by healthcare professionals as the anti-anxiety/antidepressant agent of choice for potentially suicidal patients.

Which is it? Highly dangerous substance of abuse, or safe effective medication that was a victim of mass hysteria?

Every beneficial drug can be dangerous when used incorrectly.
– EvorlorMar 26 '15 at 14:33

(1) The dose makes the poison; (2) Plenty of dangerous substances were used as medications - sometimes with legitimate efficacy - throughout history. Including coke, opium, led, etc...
– user5341Mar 27 '15 at 18:07

1

I'll add that Life Extension Magazine isn't a highly trustworthy source for drug and supplement claims, largely due to their penchant for extrapolating from test tube and animal studies. However, they do rely on a research base for their recommendations, and so they'd be unlikely to recommend something that can easily kill you.
– octernMar 30 '15 at 21:20

2 Answers
2

GHB is a fairly safe medication as long as it's not mixed with alcohol or other depressants, which can be fatal. An overdose can cause deep, unresponsive sleep with lowered respiration, but even at high doses it doesn't depress respiration enough to be dangerous (this is distinct from alcohol and opiates, which cause increasing respiratory depression with increasing dosage). Many sources refer to this state as a "coma," but this is either a misunderstanding or deliberate misrepresentation.

Another potential source of confusion is that GHB is naturally present in the body, and may be produced in large quantities as a protective factor against hypoxia. This means that when an individual dies due to unrelated causes, such as a heart attack, an autopsy may find elevated levels of GHB. I'm convinced that this was what occurred in the case of Hillory Farias, the woman whose death led to the federal ban on GHB even though there was no evidence that she'd actually taken GHB, but this is non-peer-reviewed speculation on my part.

If you look at human and animal research on GHB that was done before the late 90s, when the media started associating it with drug-war hysteria, you'll see researchers routinely administering doses in the supposedly dangerous 3-5g range with no reports of serious adverse reactions (see below for some examples). Concerns only developed when it was perceived as a "party drug" or a "date-rape drug." Since then its Schedule I status has curtailed research, but it continues to be used in research on narcolepsy and reducing the effects of alcohol withdrawal.

One complication is that GHB can increase the depressant effects of alcohol, leading to potentially fatal alcohol intoxication. This is the likely mechanism behind nearly all reported GHB fatalities. Thus, it can be true that GHB is dangerous in the context of uncontrolled recreational use, even though it's also true that it's not particularly dangerous when used on its own.

Another issue is that the solutions you find the substance in can differ.

It is used in minor doses to combat narcolepsy. The dose I can find is about 25mg/kg, or 2.25g twice per night, 3-4 hrs between the takes. ( Source 1 - Source 2 )

"The only common medical applications for GHB today are in the
treatment of narcolepsy and more rarely alcoholism."

In short, it can be consumed safely, but the amount must be quite small to avoid too hard of an impact.

"GHB tends to cause rapid unconsciousness at doses above 3500 mg, with single doses over 7000 mg often causing life-threatening
respiratory depression, and higher doses still inducing bradycardia
and cardiac arrest. Other side-effects include convulsions (especially
when combined with stimulants), and nausea/vomiting (especially when
combined with alcohol)"

"2.25g twice per night" doesn't seem to me a "minor dose", if it "tends to cause rapid unconsciousness at doses above 3500 mg, with single doses over 7000 mg often causing life-threatening respiratory depression". Is it one of the drugs whose effective dose is dangerously close to (e.g. same order of magnitude as) the lethal dose?
– ChrisWMar 26 '15 at 18:14

User dose is between 0.5 and 5 mg\ml, and read that it's 25mg per kilo. I could not see the details there, but if we say that a fully grown man can be about 100 kg, the 25 mg\kg makes sense. It's also heavily regulated, so I think the listings are more estimates\averages than fully go-to doses.
– SharainMar 26 '15 at 18:23

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If the dosages described as causing "rapid unconsciousness" and "life-threatening respiratory depression" were accurate, then -- even when adjusting for individual body weight -- it sounds like GHB would have a therapeutic index under 2. Drugs with a range that narrow are considered highly dangerous and only given with appropriate monitoring. The literature doesn't describe that level of caution or monitoring in the lab or clinical trials. Of course, that doesn't prove there weren't any adverse events. Possibly we could find out more by digging into the federal clinical trials registry.
– octernMar 30 '15 at 21:13